A danger of drowning exists in all bodies of water. The danger increases when the body of water is murky or large, if the swimmer is young or under the influence or alcohol, or if a lifeguard is not present. The watchful eye of a parent or friend can reduce the danger, but most parents are not lifeguards trained to recognize a distressed or drowning swimmer. Often times, a child can slip below the surface of dark water without notice, becoming virtually impossible to see, or, in a crowded pool, a child's thrashing arms can be confused with youthful exuberance and play.
A swimmer generally moves through several stages of drowning before succumbing to death. Most drownings are wet drownings, in which the victim breathes in water. Much rarer are dry drownings, in which the victim's throat uncontrollably spasms, causing it to shut and suffocate the victim. In a wet drowning, a swimmer typically initially becomes tired and will alternate to an easier stroke to move forward, will float on his back, or will reach for a buoy or lane line to rest. A swimmer may perceive the danger he is in and signal for help. He can respond to a rescuer's questions without panic and is not in immediate risk of death.
Once the swimmer becomes anxious or begins to panic, however, he becomes a distressed swimmer. A distressed swimmer no longer makes forward progress and is unable to keep his head above water. He may be able call out and wave his arms for help, but only has a few minutes before he becomes a drowning victim. Time is of the essence, but a distressed swimmer still has some time to appreciate the danger he is in and alert onlookers before he begins to drown.
When a swimmer becomes a drowning victim, he generally enters the active drowning stage first. The swimmer can no longer effectively call out or wave for help, but instead flails his arms to the side in an attempt to press down on the water and keep his head above the surface. His head is seldom above water, however, and when it is, his focus is on catching a breath of air and not on crying out for help. An actively drowning swimmer is typically vertical in the water.
An actively drowning victim who is not rescued will slip into unconsciousness and become a passive drowning victim. A passive drowning victim stops flailing, stops breathing, stops moving, and floats face down just below the surface, or, more likely, begins to sink downward. Immediate rescue of such a victim is necessary to quickly restore circulation of oxygen and possibly blood throughout the swimmer's body.
Lifeguards are trained to recognize the various stages of drowning and are employed to intervene when a swimmer becomes distressed. However, a lifeguard is not always present, and parents and friends may not recognize the severity of the situation. Moreover, a swimmer in the ocean may be too far out to be heard, or the sound of the surf may cover his cries for help. Onlookers may assume the swimmer is joking or playing around, or they may not want to risk embarrassment should they try to rescue a swimmer not in distress. However, because active drowning victims are struggling to breathe, moments away from unconsciousness, and cannot alert onlookers of their danger, those assumptions and fears of embarrassment can have dire consequences. Moreover, because distressed or actively drowning swimmers focus primarily on keeping their head above water, they may not be able to call out to onlookers to inform them that the danger is real.